| 1. |
- Heikkilä, Katriina, et al.
(författare)
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Job strain and COPD exacerbations: an individual-participant meta-analysis
- 2014
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Ingår i: European Respiratory Journal. - : European Respiratory Society (ERS). - 0903-1936 .- 1399-3003. ; 44:1, s. 247-251
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Tidskriftsartikel (refereegranskat)abstract
- To the Editor:Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and disability worldwide (1). The clinical course of COPD is characterised by exacerbations, which can be minor and manageable at home or in primary care, or severe, leading to hospitalisation or even death. Known causes of exacerbations include tobacco smoke, air pollution, dusts and fumes, and respiratory infections (1, 2). One less well understood risk factor is stress, which could plausibly lead to COPD exacerbations as it can trigger inflammation (3, 4) and is associated with increased smoking (5), which are both implicated in COPD pathology (2). Work is an important source of stress in the age groups in which COPD is typically diagnosed (1, 6). However, we are not aware of previous investigations of work-related stress and the risk of COPD exacerbations.In this study, we examined the associations between job strain (the most widely studied conceptualisation of work-related stress) and severe COPD exacerbations using individual-level data from 10 prospective cohort studies from the Individual Participant Data Meta-analysis in Working Populations (IPD-Work) Consortium (7). Job strain is defined as a combination of high demands (excessive amounts of work) and low control (having little influence on what tasks to.
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| 2. |
- Ahlstrand, Inger, et al.
(författare)
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Health-promoting factors among students in higher education within health care and social work : a cross-sectional analysis of baseline data in a multicentre longitudinal study
- 2022
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.Methods: This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).Results: Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.Conclusions: Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.
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| 3. |
- Johnsen, Anna M., et al.
(författare)
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Association between occupational physical activity and myocardial infarction : A prospective cohort study
- 2016
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 6:10
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Tidskriftsartikel (refereegranskat)abstract
- Objective Recommendations regarding physical activity typically include both leisure time and occupational physical activity. However, the results from previous studies on occupational physical activity and the association with myocardial infarction have been inconsistent. The aim of this study was to investigate if occupational physical activity is associated with the risk of myocardial infarction. Design Prospective cohort study. Participants Data from the Swedish Work, Lipids and Fibrinogen (WOLF) study was used, comprising 9961 employees (6849 men, 3112 women, mean age 42.7 years) having no history of myocardial infarction. The participants were categorised into 3 groups according to their level of occupational physical activity. Outcome Data regarding incident myocardial infarction were obtained from the Swedish National Patient Register and the Cause of Death Register. Cox proportional hazard regression was used for estimation of HRs for different levels of occupational physical activity in relation to the risk of myocardial infarction. Results During a mean follow-up of 13.1 years, 249 cases of incident myocardial infarction were identified. In analyses adjusted for age, sex and socioeconomic status, participants standing and walking more than 50% of their working day had an HR of 1.13 (95% CI 0.83 to 1.54), compared with participants seated more than 50% of their working day. The corresponding HR for participants whose work included lifting or carrying was 0.86 (95% CI 0.59 to 1.24). Further adjustment did not alter the results. Stratified analyses resulted in a significantly decreased risk for young people whose work included lifting or carrying, HR 0.37 (95% CI 0.17 to 0.84), compared with younger persons who sat most of their working day. Conclusions No significant association between occupational physical activity and the risk of myocardial infarction was observed in the total group of employees in this study. Based on the results from this study, occupational physical activity in general does not seem to be enough for reducing the risk of myocardial infarction.
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| 4. |
- Virtanen, Marianna, et al.
(författare)
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Long working hours and alcohol use : systematic review and meta-analysis of published studies and unpublished individual participant data.
- 2015
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Ingår i: BMJ (Clinical research ed.). - : BMJ. - 1756-1833 .- 0959-8138. ; 350, s. Art. no. g7772-
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To quantify the association between long working hours and alcohol use.DESIGN: Systematic review and meta-analysis of published studies and unpublished individual participant data.DATA SOURCES: A systematic search of PubMed and Embase databases in April 2014 for published studies, supplemented with manual searches. Unpublished individual participant data were obtained from 27 additional studies.REVIEW METHODS: The search strategy was designed to retrieve cross sectional and prospective studies of the association between long working hours and alcohol use. Summary estimates were obtained with random effects meta-analysis. Sources of heterogeneity were examined with meta-regression.RESULTS: Cross sectional analysis was based on 61 studies representing 333 693 participants from 14 countries. Prospective analysis was based on 20 studies representing 100 602 participants from nine countries. The pooled maximum adjusted odds ratio for the association between long working hours and alcohol use was 1.11 (95% confidence interval 1.05 to 1.18) in the cross sectional analysis of published and unpublished data. Odds ratio of new onset risky alcohol use was 1.12 (1.04 to 1.20) in the analysis of prospective published and unpublished data. In the 18 studies with individual participant data it was possible to assess the European Union Working Time Directive, which recommends an upper limit of 48 hours a week. Odds ratios of new onset risky alcohol use for those working 49-54 hours and ≥55 hours a week were 1.13 (1.02 to 1.26; adjusted difference in incidence 0.8 percentage points) and 1.12 (1.01 to 1.25; adjusted difference in incidence 0.7 percentage points), respectively, compared with working standard 35-40 hours (incidence of new onset risky alcohol use 6.2%). There was no difference in these associations between men and women or by age or socioeconomic groups, geographical regions, sample type (population based v occupational cohort), prevalence of risky alcohol use in the cohort, or sample attrition rate.CONCLUSIONS: Individuals whose working hours exceed standard recommendations are more likely to increase their alcohol use to levels that pose a health risk.
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| 5. |
- Kivimäki, Mika, et al.
(författare)
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Associations of job strain and lifestyle risk factors with risk of coronary artery disease : a meta-analysis of individual participant data
- 2013
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Ingår i: CMJA. Canadian Medical Association Journal. Onlineutg. Med tittel. - : CMA Joule Inc.. - 0820-3946 .- 1488-2329. ; 185:9, s. 763-769
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Tidskriftsartikel (refereegranskat)abstract
- Background: It is unclear whether a healthy lifestyle mitigates the adverse effects of job strain on coronary artery disease. We examined the associations of job strain and lifestyle risk factors with the risk of coronary artery disease.Methods: We pooled individual-level data from 7 cohort studies comprising 102 128 men and women who were free of existing coronary artery disease at baseline (1985–2000). Questionnaires were used to measure job strain (yes v. no) and 4 lifestyle risk factors: current smoking, physical inactivity, heavy drinking and obesity. We grouped participants into 3 lifestyle categories: healthy (no lifestyle risk factors), moderately unhealthy (1 risk factor) and unhealthy (2–4 risk factors). The primary outcome was incident coronary artery disease (defined as first nonfatal myocardial infarction or cardiac-related death).Results: There were 1086 incident events in 743 948 person-years at risk during a mean follow-up of 7.3 years. The risk of coronary artery disease among people who had an unhealthy lifestyle compared with those who had a healthy lifestyle (hazard ratio [HR] 2.55, 95% confidence interval [CI] 2.18–2.98; population attributable risk 26.4%) was higher than the risk among participants who had job strain compared with those who had no job strain (HR 1.25, 95% CI 1.06–1.47; population attributable risk 3.8%). The 10-year incidence of coronary artery disease among participants with job strain and a healthy lifestyle (14.7 per 1000) was 53% lower than the incidence among those with job strain and an unhealthy lifestyle (31.2 per 1000).Interpretation: The risk of coronary artery disease was highest among participants who reported job strain and an unhealthy lifestyle; those with job strain and a healthy lifestyle had half the rate of disease. A healthy lifestyle may substantially reduce disease risk among people with job strain.
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| 6. |
- Ohlsson, Ann-Christine, et al.
(författare)
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Potential Risk Factors and Prevalence of Voice Symptoms in Students Starting Their Teacher Education
- 2021
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Ingår i: Journal of Voice. - : Elsevier BV. - 0892-1997 .- 1873-4588. ; 35:2, s. 1-323
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to determine prevalence of voice problems and potential risk factors in teacher students at the start of their education. A total of 1494 students from seven teacher education schools participated in the study. The students answered a questionnaire about 11 risk factors, and one with six questions about voice symptoms, Screen6, and 30 statements in the Voice Handicap Index (VHI). Students reporting at least 2 weekly voice symptoms in Screen6 were assigned to the group with voice problems. Significance level was P < 0.05. Results: prevalence of risk factors was about the same in the seven groups of teacher students except the group with highest proportion of women that also showed the highest proportion of voice problems, 38%. Prevalence of voice problems in the total group was 17%. Comparison of students with or without voice problems showed that all factors except one were more prevalent among students with voice problems and women were overrepresented. Mean total VHI score was 22 in students with voice problems and eight in students without voice problems. Multiple regression analyses showed that frequent throat infections, hearing problems, previous speech therapy, or voice training were the potential risk factors that had the strongest association with voice symptoms as well as with total score in VHI. Conclusions: results from this study show that it is common that teacher students experience voice problems already at the start of their education and potential risk factors associated with voice problems are identified. Knowing that teaching is a high-risk profession for developing voice disorders, it is crucial that teacher students should receive compulsory preprofessional voice education including voice ergonomics and voice training.
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| 7. |
- Lindmark, Ulrika, 1965-, et al.
(författare)
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Health-promoting factors in higher education for a sustainable working life : protocol for a multicenter longitudinal study
- 2020
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Ingår i: BMC Public Health. - London : BioMed Central. - 1471-2458. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work. METHODS: This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions. DISCUSSION: This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.
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| 8. |
- Håkansson, Carita, et al.
(författare)
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Construct validity of a revised version of the Occupational Balance Questionnaire
- 2020
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 27:6, s. 441-449
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Tidskriftsartikel (refereegranskat)abstract
- Background: Occupational balance is fundamental to occupational therapy and occupational science. Therefore, the Occupational Balance Questionnaire (OBQ) was developed and has previously been found psychometrically valid according to classical test theory. Aim: To investigate the internal construct validity of the OBQ using Rasch measurement theory. Material and methods: Data from two general population samples were used to investigate the psychometric properties of the OBQ according to Rasch measurement theory. Results: The analyses identified problems with the current response scale and multidimensionality of two items. As a result, a revised version, the OBQ11, was suggested and exhibited response categories that worked properly, good reliability (0.92), model fit and measurement invariance across age and gender groups. The hierarchical item ordering was in agreement with previous research. Conclusion: The new OBQ11 satisfies the measurement criteria defined by the Rasch model. However, further studies of additional samples are needed to validate its generic properties. Significance: The purpose of the OBQ11 is to measure occupational balance of individuals or groups, and to identify aspects of occupational balance in need of improvement. Our observations suggest that the OBQ11 is a valid and promising complement to other instruments.
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| 9. |
- Lindegård, Agneta, et al.
(författare)
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Perceived exertion, comfort and working technique in professional computer users and associations with the incidence of neck and upper extremity symptoms.
- 2012
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Ingår i: BMC Musculoskeletal Disorders. - London : BioMed Central. - 1471-2474. ; 13, s. 38-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of this study was to investigate whether perceived exertion, perceived comfort and working technique is associated with the incidence of neck and upper extremity symptoms among professional computer users. METHODS: At baseline a self-administered questionnaire was distributed to 853 participants from 46 different work sites (382 men and 471 women) who, at baseline, had been free from neck and upper extremity symptoms during the preceding month. Work-related exposures, individual factors, and symptoms from the neck and upper extremities were assessed. Observations of working technique were performed by ergonomists using an ergonomic checklist. Incidence data were collected by means of 10 monthly questionnaires, asking for information on the occurrence of neck, shoulder and arm/hand symptoms. Perceived exertion was rated on a modified Borg RPE scale ranging from 0 (very, very light) to 14 (very, very strenuous). Perceived comfort was rated on a 9-point scale ranging from -4 (very, very poor) to +4 (very, very good) in relation to the chair, computer screen, keyboard, and computer mouse. RESULTS: The median follow up time was 10.3 months. The incidence of symptoms from the neck, shoulders and arm/hands were 50, 24 and 34 cases per 100 person years, respectively.Higher perceived exertion in the neck, shoulder or arm/hands was associated with an increased risk of developing symptoms in the corresponding body region. Moreover, a dose-response relationship between the level of exertion and the risk of developing symptoms was recorded for all three regions. There was an association between low comfort and an increased risk for neck symptoms, but not for shoulder and arm/hand symptoms, although a trend towards such an association (not statistically significant) could be seen. Working technique was, in this study, not associated with the risk of developing symptoms in any of the investigated body regions. CONCLUSION: There was a strong association between high perceived exertion and the development of neck, shoulder, and arm/hand symptoms. Moreover, there was an association between poor perceived comfort and neck pain. Surveillance of computer users may include perceived exertion and comfort to target individuals at risk for neck and upper extremity symptoms.
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| 10. |
- Kivimäki, Mika, et al.
(författare)
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Work stress and risk of death in men and women with and without cardiometabolic disease : a multicohort study
- 2018
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Ingår i: The Lancet Diabetes and Endocrinology. - : Elsevier. - 2213-8587 .- 2213-8595. ; 6:9, s. 705-713
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although some cardiovascular disease prevention guidelines suggest a need to manage work stress in patients with established cardiometabolic disease, the evidence base for this recommendation is weak. We sought to clarify the status of stress as a risk factor in cardiometabolic disease by investigating the associations between work stress and mortality in men and women with and without pre-existing cardiometabolic disease.METHODS: In this multicohort study, we used data from seven cohort studies in the IPD-Work consortium, initiated between 1985 and 2002 in Finland, France, Sweden, and the UK, to examine the association between work stress and mortality. Work stress was denoted as job strain or effort-reward imbalance at work. We extracted individual-level data on prevalent cardiometabolic diseases (coronary heart disease, stroke, or diabetes [without differentiation by diabetes type]) at baseline. Work stressors, socioeconomic status, and conventional and lifestyle risk factors (systolic and diastolic blood pressure, total cholesterol, smoking status, BMI, physical activity, and alcohol consumption) were also assessed at baseline. Mortality data, including date and cause of death, were obtained from national death registries. We used Cox proportional hazards regression to study the associations of work stressors with mortality in men and women with and without cardiometabolic disease.RESULTS: We identified 102 633 individuals with 1 423 753 person-years at risk (mean follow-up 13·9 years [SD 3·9]), of whom 3441 had prevalent cardiometabolic disease at baseline and 3841 died during follow-up. In men with cardiometabolic disease, age-standardised mortality rates were substantially higher in people with job strain (149·8 per 10 000 person-years) than in those without (97·7 per 10 000 person-years; mortality difference 52·1 per 10 000 person-years; multivariable-adjusted hazard ratio [HR] 1·68, 95% CI 1·19-2·35). This mortality difference for job strain was almost as great as that for current smoking versus former smoking (78·1 per 10 000 person-years) and greater than those due to hypertension, high total cholesterol concentration, obesity, physical inactivity, and high alcohol consumption relative to the corresponding lower risk groups (mortality difference 5·9-44·0 per 10 000 person-years). Excess mortality associated with job strain was also noted in men with cardiometabolic disease who had achieved treatment targets, including groups with a healthy lifestyle (HR 2·01, 95% CI 1·18-3·43) and those with normal blood pressure and no dyslipidaemia (6·17, 1·74-21·9). In all women and in men without cardiometabolic disease, relative risk estimates for the work stress-mortality association were not significant, apart from effort-reward imbalance in men without cardiometabolic disease (mortality difference 6·6 per 10 000 person-years; multivariable-adjusted HR 1·22, 1·06-1·41).INTERPRETATION: In men with cardiometabolic disease, the contribution of job strain to risk of death was clinically significant and independent of conventional risk factors and their treatment, and measured lifestyle factors. Standard care targeting conventional risk factors is therefore unlikely to mitigate the mortality risk associated with job strain in this population.FUNDING: NordForsk, UK Medical Research Council, and Academy of Finland.
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